Active NPI
Keith E. Knepp, M.D.
- Family Medicine Physician
- Eureka, IL
National Provider Identifier
1982623666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Practice address
- 105 S Major St
Eureka, IL 61530-1246 - Phone
- (309) 467-4691
- Fax
- (309) 467-6229
- NPI assigned
- Jul 19, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | IL | Primary |
Addresses
Primary practice location
105 S Major St
Eureka, IL 61530-1246
Mailing address
PO Box 2451
Bloomington, IL 61702-2451
Phone (309) 268-2172
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10215111 | Other | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036100700 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proctor Community Hospital | Past | Accepting new patients | |
| Proctor Health Systems | Family Medicine | Past | Accepting new patients |
| Belcrest Services, LTD | Past | Accepting new patients | |
| Quincy Physicians & Surgeons Clinic, PLLC | Past | Accepting new patients | |
| Pekin Prohealth Inc | Family Medicine | Past | Accepting new patients |
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Durable Medical Equipment & Medical Supplies
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982623666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2451",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617022451",
"telephone_number": "309-268-2172",
"fax_number": "309-268-3649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 S MAJOR ST",
"city": "EUREKA",
"state": "IL",
"postal_code": "615301246",
"telephone_number": "309-467-4691",
"fax_number": "309-467-6229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNEPP",
"first_name": "KEITH",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "10215111",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Eureka, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.